Texicare

Business Intelligence Developer

• Build and maintain interactive dashboards and visualizations that answer recurring questions (finance, ops, clinical, and/or provider network).
• Maintain and update KPI definitions (logic, filters, grain) and publish them in the semantic layer and glossary.
• Support the development of self-service models used by business users.
• Ensure visuals are intuitive, performant, and consistently drive actionable insights.
• Collaborate with internal teams to interpret dashboards and reports and identify opportunities to improve financial performance, care efficiency, and population health outcomes.
• Manage daily stakeholder needs, including backlog triage, expectation setting, and storytelling.
• Execute ad-hoc requests: clarify the question, pull data, summarize findings, and recommend next steps.
• Perform initial root-cause analysis when anomalies surface (e.g., spike in missing NPIs, margin swings) before involving Data team.
• Audit and validate numbers against source-of-truth reports; raise issues with clear evidence and outline steps to reproduce.
• Contribute to metric tests/alerts in SQL; log and track defects.
• Create and update how-to guides, data dictionaries, and dashboard “user guides.”
• Educate business users on self-service techniques; host office hours or quick hits training sessions.
• Provide feedback to Data team on missing fields, semantic gaps, or modeling optimizations.
• Monitor dashboard performance and utilization.

Business Intelligence Analyst

Operations

• Manage the daily operations of health plan functions, including claims processing, enrollment/customer onboarding, eligibility, and provider contract management, including but not limited to direct management of the third-party administrator for these vended services.
• Serve as claims domain expert, supporting the business, technology, finance teams and other stakeholders to ensure cost efficient and compliant claims processing, payment, preparation and submission of regulatory deliverables, high-cost claims review and check run/provider payments.
• Lead operational implementation of new technology, systems, and products that enable claims and operational workflows; define requirements, test outcomes, support change readiness, and coordinate go-live stabilization (including vendor/platform transitions as applicable).
• Create and maintain payment and reimbursement policies, claims processes, procedures and workflows, and continuously monitor and evaluate performance of the claims operations against those standards.
• Coordinate across departments for proper alignment and effective administration of medical management requirements of hospital contracts; ensure that contract terminology, interpretation, and pricing issues are consistent with company cost-containment objectives.
• Accountable for ensuring Health Plan Operations metrics meet and/or exceed all compliance requirements, performance targets and service level agreements.
• Attract, retain, develop, and motivate a high-performance team by fostering an inclusive work environment, using a coaching approach, and communicating and exemplifying Texicare’s vision, values, and strategy.

Business Intelligence Analyst

Manager – Senior Manager, Claims and Health Plan Operations